Provider Demographics
NPI:1033913363
Name:KANDAH, MAYA (MD)
Entity type:Individual
Prefix:
First Name:MAYA
Middle Name:
Last Name:KANDAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 W CHAPMAN AVE STE 6200
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-1640
Mailing Address - Country:US
Mailing Address - Phone:626-848-4947
Mailing Address - Fax:
Practice Address - Street 1:3800 W CHAPMAN AVE STE 6200
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-1640
Practice Address - Country:US
Practice Address - Phone:626-848-4947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program